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Asthma in the Workplace. 2nd Edition Leonard Bernstein, Moira Chan-Yeung, Jean-Luc Malo, David I Bernstein, Editors. (Pp 742, hardback; $225.00). New York: Marcel Dekker, 1999. ISBN 0 8247 1963 8
Asthma caused by occupational exposures accounts for a small but important proportion of cases seen by most practising physicians. In clinical practice occupational asthma can be difficult to recognise, and once diagnosed can present substantial difficulties for both patient and physician, particularly when the diagnosis means that to a greater or lesser degree someone is going to have to change their occupation completely, or at least adopt very different working practices. The individual social and economic implications of these changes can be substantial. Given the immense scale of the spectrum of the causes of occupational asthma, it is also inevitable that many clinicians are relatively inexperienced in identifying and dealing with specific exposures. Most clinicians therefore will at some stage need a definitive and authoritative text on occupational asthma, and this book goes a great deal of the way to meeting that need.
The strength of the book is not so much in the breadth of the topics that it covers, which is essentially the same as that found in the relevant sections of any major respiratory textbook. The advantage of this text is its detail. For example, many textbook chapters include a list of exposures that have been implicated in occupational asthma, but often do not provide the specific sources of information for many exposures listed. The referencing in this book is extremely extensive, and the reader who wishes to look up detailed background material will find most of the important references listed here. This book thus provides the necessary resource for the clinician faced with an individual patient with an individual occupational exposure to investigate what is known about that exposure, and to give the patient some context for his/her own disease. This is also likely to be very helpful for those physicians who become involved in the compensation and medicolegal arguments that may then ensue. Beyond the breadth of the literature covered by the book, there are strong chapters on the generic methodology of occupational asthma and extensive reviews of individual causes. Overall this book is a powerful resource and, on the strength of that, probably justifies its cost.—JB